A motorcyclist has an increased risk of injury every time they get on their bike and get on the road. There is no barrier to protect them in the case of a crash or accident. Because of this, motorcycle injuries sustained can be life-changing. The most common injuries that motorcycle riders sustain and suffer when involved in accidents and crashes tend to be related to high traffic, speed, distracted drivers, and construction. This means that most common motorcycle accidents and crash injuries are severe.
Road Rash
Also known as road burn. This is a type of burn that is caused when the body’s skin gets badly scraped and shredded from the road. This often happens when a rider is thrown from the motorcycle skidding down the road before coming to a stop. Road rash can happen on any part of the body. For motorcyclists, it is common on the legs, hands, arms, and back. It can be excruciating even though the injury is not considered fatal, complications and overlapping injuries can develop. This is usually in the form of infections that can affect mobility and flexibility issues that can require further medical intervention and rehabilitation. In severe cases, it can require skin grafts. Depending on the severity it can leave permanent scarring. Treatment often includes antibiotics, bandage dressings, burn soothing and disinfectant creams.
Fractures and Broken Bones
When a motorcycle and a vehicle collide, it is very common for the motorcyclist to get thrown or knocked off with intense force. When the rider hits the ground, the impact alone can cause fractures and breaks. If the rider lands at an awkward angle this can definitely cause a fracture or break. Broken bones can happen anywhere on the body, but are most commonly sustained in the arms and legs. Broken ribs are also common and usually occur when the motorcyclist gets hit or falls hard. Motorcycle endorsement classes emphasize the ATGATT system that stands for All The Gear, All The Time. This means wearing motorcyclist protective clothing and ankle-high boots. Ankle injuries and fractures are commonly sustained from operating a motorcycle.
Spinal Cord Injuries
If the spinal cord gets injured or damaged the results can be devastating. Depending on the area of the injury, an individual might not be able to walk, use their arms, or move at all. Spinal cord injuries tend to happen when the motorcyclist gets thrown hard or up in the air landing hard on their neck, back, or the body gets pierced by an object. Spine fractures often happen when the rider gets pinned or crushed between vehicles and objects. This can cause temporary or permanent paralysis.
Traumatic Brain Injury
This is one of the most serious injuries sustained in a motorcycle crash. Traumatic brain injury – TBI is when the brain sustains trauma. These injuries usually happen when a motorcyclist is involved in an accident and is not wearing a helmet, their head hits an object forcefully, the head is shaken violently back and forth, or if the skull gets punctured. Around 15% of motorcyclists involved in accidents that receive medical treatment are diagnosed with a traumatic brain injury. When a person sustains a TBI, they can develop physical and cognitive deficits. Depending on the severity, brain injuries can be treated with surgery, traction, and rehabilitation, but can have lifelong effects.
Organ Injury and Damage
Intense and forceful impacts can cause internal organ damage. Internal bleeding is common in motorcycle accidents. This can be fatal if not diagnosed and treated. Injuries that prove to be fatal, more than three-quarters are caused by traumatic brain injury.
Therapy Rehabilitation
Our experienced team of accident physical therapists and chiropractic team will review the details of the collision, medical treatments and develop a thorough rehabilitation plan. Call our team today and let us help you put your life back together.
Body Composition
Breakfast and Mental Health
Beyond an individual’s physical health, breakfast can significantly impact mood and mental health. According to a 2018 study, a healthy high-quality breakfast has been shown to reduce stress and depression in adolescents. Breakfast nutritional quality was based on individual responses to the following questions:
Do you have cereal or other grain-based products bread, toast, etc?
Do you have some type of dairy product for breakfast?
Do you have commercially baked goods like biscuits or pastries for breakfast?
If a participant stated they consumed commercially baked goods and did not eat bread/toast/cereal or dairy products for breakfast, this was considered a poor quality breakfast. Avoiding commercially baked goods altogether and eating whole bread, healthy cereals, and/or dairy products was considered a good quality breakfast. Choosing grain-based foods along with dairy products was considered healthy because these foods provide a wide range of nutrients. Healthy cereals can provide:
Protein
Carbohydrates
Micronutrients
Results found that individuals that ate healthy quality breakfasts had:
Reduced mental distress
Reduced depressive symptoms
Increased positive mood
Improved quality of life
References
Alicioğlu, Banu et al. “Motosiklet kazalarina bağli yaralanmalar” [Injuries associated with motorcycle accidents]. Acta orthopaedica et traumatologica turcica vol. 42,2 (2008): 106-11.
Araujo, Miguel et al. “Effectiveness of interventions to prevent motorcycle injuries: a systematic review of the literature.” International journal of injury control and safety promotion vol. 24,3 (2017): 406-422. doi:10.1080/17457300.2016.1224901
Dupaix, John P et al. “A Comparison of Skeletal Injuries Arising from Moped and Motorcycle Collisions.” Hawai’i journal of health & social welfare vol. 78,10 (2019): 311-315.
Elsemesmani, Hussein et al. “Association Between Trauma Center Level and Outcomes of Adult Patients with Motorcycle Crash-Related Injuries in the United States.” The Journal of emergency medicine vol. 59,4 (2020): 499-507. doi:10.1016/j.jemermed.2020.06.018
Peng, Yinan et al. “Universal Motorcycle Helmet Laws to Reduce Injuries: A Community Guide Systematic Review.” American journal of preventive medicine vol. 52,6 (2017): 820-832. doi:10.1016/j.amepre.2016.11.030
Bowling is a fun physical activity that is enjoyable for all ages. Today, there are college bowlers, recreational bowlers, amateur, semiprofessional, professional leagues, and tournaments worldwide. Although it might not be the first sport that comes to mind when thinking of injuries and chronic pain conditions, it can place significant stress on the muscles and tendons of the upper and lower body. It is important to know and understand how to avoid injuries.
How Bowling Injuries Happen
There are two main causes of injuries and chronic pain related to bowling. The first is poor mechanics, and the second is repetitive over-use. Both cause/develop painful symptoms that can turn into injuries that become chronic conditions. Many injuries are caused by:
Slip and fall accidents
Players dropping the ball on their feet
The majority of injuries come from overuse/repetition and improper body mechanics.
Overuse injuries result from repetitive and/or strenuous actions/movements that place profound stress on the body’s musculoskeletal system.
For example, a semi-pro and professional bowler will play fifty or more games a week. This means throwing a sixteen-pound ball for ten frames per game. When consistently repeated over and over, this can cause serious wear and tear to the body. With amateur and recreational bowlers, they don’t play as much, so they don’t experience overuse injury as much, but what they do experience is improper/poor form techniques that shift the body in non-ergonomic ways, wrong equipment like oversized/too-small shoes that can cause awkward postures and body motions, a ball that is too heavy causing an individual to overthrow and strain their arms, backs, hips, and legs. Or a ball with small finger holes that get stuck or too large, causing finger, hand, arm, shoulder pulls strains, and sprains.
Common Bowling Injuries
The most common injuries and conditions associated with bowling include:
Many of the injuries can lead to tendonitis or arthritis later in life.
Trigger/Bowler’s Finger
Symptoms include:
Hand pain after bowling, specifically in the fingers
A clicking or popping when moving the fingers
A finger gets locked in a bent position
Rest, and no bowling is recommended. How long a rest depends on how long the symptoms have been presenting. Physical therapy, along with chiropractic exercises, can help improve finger strength. Splinting the finger could be required to improve the condition. If all fails or does not generate adequate relief, hand surgery could be optioned with a trigger finger release. The surgery allows the finger to move more freely.
Bowler’s Thumb
This usually happens to bowlers that want to generate a lot of spin on the ball. If the thumb’s hole is too tight, it can pinch the ulnar nerve inside the thumb. If the thumb injury is not serious, rest and getting the correct ball size can correct the issue. This is where purchasing a personal bowling ball can help.
Finger Sprain
This is an injury to one or more of the ligaments in the fingers. It most often takes place in the collateral ligaments along the sides of the fingers inside the ball. The ligament/s gets stretched or torn when the finger is forced beyond its normal range of motion. Common symptoms of a finger sprain include swelling, tenderness, stiffness, and pain in the affected finger. This usually occurs from:
The weight of holding the ball with the fingers alone
A poor release
Using a ball that doesn’t properly fit the fingers
A finger sprain falls into grades on the severity of how much the ligament is stretched or torn:
Grade 1
Stretching or microscopic tearing.
Grade 2
Less than 90% of the ligament is torn.
Grade 3
More than 90% of the ligament is torn. Grade three sprains can be accompanied by joint instability and immobility.
Herniated Disc
A herniated disc is when the discs get injured/damaged from overuse, wear, and tear, or a traumatic injury to the spine. The disc can dry out, become less flexible, bulge out, or rupture. Bowlers are constantly:
Bending during the final approach and throw
Carrying a heavy ball
Shifting, twisting, and releasing, increasing the pressure within the discs
In bowling, the majority of herniated discs happen in the low back. The most common symptom is backaches and back pain. Lumbar herniated discs left untreated can cause sciatica.
Avoid and Prevent Injury
The best way to prevent injury is to stay aware of body position, mechanics, equipment, and what the body says.
Stretching
Stretching is one of the best things to avoid injury before practicing, competing, or just playing. Stretching will increase flexibility, especially in the wrist, hand, arm, and low back.
Improving technique
Continually using poor techniques over and over is a perfect set-up for injury. Working with a coach will ensure the proper form. This is important when it comes to generating spin on the ball, as well as, making sure the grip does not place too much strain on the hands.
Using the right ball
The ball being used might not be the right fit for your hand or strength. The holes could be too far apart, causing strain on the fingers. Get as much information as possible and try out different styles and weights to get a comfortable feel for the right ball.
Bowling less
Hard-core bowlers could be overdoing it. Cutting back, and creating a balance will allow the body to recover thoroughly and not cause flare-ups.
Getting in shape
Studies show that individuals who bowl and do not exercise significantly increase the risk of a back injury than those who exercise their back and core. Bowling is not as strenuous as other sports, but it still requires the body to be able to handle the stress.
Body Health
Test Body Composition
Testing body composition regularly is the best way to ensure the body stays healthy. Tracking body composition tracks Lean Mass and Fat Mass gain or loss. The information provided allows the individual to make the necessary changes to ensure they stay fit and healthy.
Diet adjustment
Diet needs to be adjusted to match the individual’s current activity level, or risk running a caloric surplus. A great way to optimize diet is to use Basal Metabolic Rate which will make sure the body is getting enough nutrients to fuel muscle growth, and lose belly fat.
Physical activity that fits the new lifestyle
Increase physical activity levels that work with current lifestyle. This does not mean performing at high levels every day. Be active on a schedule that works for you. Two days of strength training a week offer great physical and mental benefits. The key is to maintain the balance between food consumption and exercise/physical activity that fits your current lifestyle.
References
Almedghio, Sami M et al. “Wii knee revisited: meniscal injury from 10-pin bowling.” BMJ case reports vol. 2009 (2009): bcr11.2008.1189. doi:10.1136/bcr.11.2008.1189
Kerr, Zachary Y et al. “Epidemiology of bowling-related injuries presenting to US emergency departments, 1990-2008.” Clinical pediatrics vol. 50,8 (2011): 738-46. doi:10.1177/0009922811404697
Kisner, W H. “Thumb neuroma: a hazard of ten pin bowling.” British journal of plastic surgery vol. 29,3 (1976): 225-6. doi:10.1016/s0007-1226(76)90060-6
Miller, S, and G M Rayan. “Bowling related injuries of the hand and upper extremity; a review.” The Journal of the Oklahoma State Medical Association vol. 91,5 (1998): 289-91.
The hands are a magnificent piece of work. Its intricate design and functional form follow the hand. However, any injury to the underlying structures of the hand can overlap with other injuries/conditions. Even the smallest hand injuries require a proper medical examination. The objective is a quick and accurate initial evaluation along with treatment. Early treatment is done quickly to minimize short and long-term effects.
Anatomy
The hand consists of 27 bones that include 8 bones in the wrist. If the associated structures:
Nerves
Arteries
Veins
Muscles
Tendons
Ligaments
Joint cartilage
Fingernails
Get injured or damaged in some way; there is increased potential for various injuries.
Causes
The most common cause of injury/s is blunt trauma, followed by injury from a sharp object. Hand injuries are divided into categories:
Symptoms vary depending on the type of injury, how the injury occurred/mechanism, the depth, severity, and location. Common symptoms:
Lacerations
Tenderness
Pain
Bleeding
Numbness
Decreased range of motion
Difficulty moving
Weakness
Pale appearance
Fractures and Dislocations
Swelling
Discoloration
Tenderness
Deformity
Reduced range of motion
Numbness
Weakness
Bleeding
Soft Tissue Injuries and Amputations
Swelling
Discoloration
Tenderness
Deformity with or without tissue loss/bone loss
Bleeding
Weakness
Numbness
Infection
Tenderness
Swelling
Warmth/Heat around the area
Redness
Deformity
Reduced range of motion
Fever is rare in hand infections
Burns
Redness
Tenderness
Blistering
Complete numbness
Discoloration
Loss of tissue
The texture of the skin change
Areas of tissue blackened
Deformity
High-pressure Injection Injury
Pain
Swelling
Bleeding
Skin discoloration
Muscle, tendon, ligament tears
Cracked/Broken bones
Medical Care
Anyone with a hand injury is recommended to call a doctor or seek medical attention. When medical attention is delayed, the possibility of worsening or creating further injuries increases. Even the smallest cut or what looks like a minor injury could require advanced treatment to prevent infection or loss of function. Any cut or laceration that requires stitches to repair should also have a medical evaluation to make sure the musculoskeletal system of the hands is functioning properly. Injuries causing the following symptoms require emergency medical attention at an emergency clinic.
Severe bleeding
Severe pain
Numbness
Loss of motion
Loss of strength
Deformity
Signs of infection – tenderness, warmth/heat, redness, swelling, pus, or fever
Exposure of structures – tendons, bones, joints, arteries, veins, or nerves
Diagnosis
A medical examination can include a medical history and physical examination.
Medical History
Past medical history
Does the patient have diabetes or arthritis?
Is the patient right or left-handed?
Occupation
Extracurricular activities and hobbies
How does the patient use their hands?
How did the injury occur, mechanism of injury?
Does the patient smoke?
Physical Exam
Visual inspection look at the injury
Sensory nerve exam feeling
Vascular exam circulation of blood supply
Muscular and tendon exam movement and strength
Bone exam broken bones or dislocated joints
Tests
A doctor will order X-rays after the history and physical exam if necessary. Certain injuries will require imaging to identify fractures/dislocations or to rule out foreign bodies. Many types of injuries can lead to compartment syndrome. Compartment syndrome is a condition in which there is swelling and an increase in pressure within a limited space or a compartment that presses on and compromises blood vessels, nerves, and/or tendons that run through that particular area. Once the immediate injury is addressed, a personalized treatment plan can be developed .to rehabilitate the hand/s to optimal function quickly
Body Composition
Artificial Sweeteners And Muscle Gain
Artificial sweeteners don’t individuals that are trying to build lean body mass. The body needs carbs after a workout for replenishing the depleted glycogen stores. Many commercially prepared protein supplements are made with artificial sweeteners that don’t provide an adequate source of carbohydrates. If an individual consumes only protein made with sugar substitutes after a workout, they are missing essential components of post-workout recovery. A study found that supplementing with carbohydrates before and during strength training can increase performance, compared to participants that were taking the artificial sweeteners saccharin and aspartame. To properly refuel after a workout, remove the artificially sweetened protein powders and replace them with a snack packed with protein and high-quality carbohydrates. These include:
Greek yogurt
Fruit with nuts or nut butter
Hummus with whole-grain crackers
Tuna
Hard-boiled eggs
References
Banting, Joshua, and Tony Meriano. “Hand Injuries.” Journal of special operations medicine: a peer-reviewed journal for SOF medical professionals vol. 17,4 (2017): 93-96.
Fuhrer, Reto et al. “Tipps und Tricks in der Behandlung offener Handverletzungen in der Notfallpraxis” [Treatment of acute injuries of the hand]. Therapeutische Umschau. Revue therapeutique vol. 77,5 (2020): 199-206. doi:10.1024/0040-5930/a001177
Harrison, BP, and M W Hilliard. “Emergency department evaluation and treatment of hand injuries.” Emergency medicine clinics of North America vol. 17,4 (1999): 793-822, v. doi:10.1016/s0733-8627(05)70098-5
MedscapeReference.com. High-Pressure Hand Injury.
MedscapeReference.com. Soft Tissue Hand Injury Differential Diagnoses.
Siotos, C et al. “Hand injuries in low- and middle-income countries: a systematic review of existing literature and call for greater attention.” Public health vol. 162 (2018): 135-146. doi:10.1016/j.puhe.2018.05.016
Anyone from young children, adults, and the elderly can get a spinal infection. Individuals can have an infection:
In vertebral bone tissue
An intervertebral disc
The spinal canal – space where the spinal cord runs through
The spinal cord’s protective lining
These types of infections can happen anywhere along the spine, from the atlas at the base of the neck to the coccyx all the way to the lowest part of the back. Individuals should expect unpredictability if dealing with a spinal infection. During testing, lab results could be misleading or inaccurate. What can happen is white blood cell counts are normal, X-rays might not show any abnormalities, and sensitive diagnostic tests like a CT or MRI scan might not show positivity of infection for a week or more. What to know about spinal infections.
Spinal Infection Types
They are classified according to the type of tissue they infect. The most common include:
Vertebral Osteomyelitis
This is a common infection type. Bacteria most often cause the cause. It can develop after trauma to the spine, post-surgery, or bacterial infections located in other body parts that travel via the blood to the vertebra. Symptoms include:
Persistent, chronic back pain that can become severe worsens at night and becomes aggravated from moving.
The pain radiates/spreads into the arms and legs
Tingling, numbness, and burning sensations
Inflammation
Fever
Weight loss
Vomiting
Post-surgery wound drainage, redness, and swelling near the surgical site
Treatment includes:
Intravenous antibiotics
Antibiotics
Over-the-counter analgesics like nonsteroidal anti-inflammatory meds for pain relief.
Prescription pain medications
Back brace
Surgery is recommended if antibiotic treatment fails, nerve damage develops, a spinal deformity develops, or to remove infected bone and/or soft tissues.
Discitis
This type of infection develops between the intervertebral discs. It is also rare, but it is more common in children and adolescents, but it can still happen in adults. Discitis can be potentially deadly, despite advanced treatment. The most common causes are bacterial and viral infections.
Symptoms
Individuals with discitis can present with minimal symptoms when the infection initializes, but it does worsen and can cause:
Abdominal pain and discomfort
Posture changes
Mobility issues
Difficulty performing everyday tasks
Fever
Severe back pain that worsens at night or by moving
Treatment options include:
Antibiotics
Anti-inflammatory medications
Supportive devices
Rest
Steroids to alleviate inflammation in chronic and severe cases
Severe cases could require surgery to restructure areas of the affected spine to improve function and mobility
Epidural Abscess
This is an infection that can develop in the spaces between the bones of the spine, the skull, or soft tissues surrounding the brain and spinal cord. This is a medical emergency that needs to be addressed immediately. The infection is often caused by a bacterial or fungal infection in or around the affected area. This is commonly a Staphylococcus aureus bacteria. In some cases, an abscess can develop from an infection in another part of the body. This could be a urinary tract infection that spreads out to the spine. Symptoms include:
Inflammation and swelling
Mid to low back pain
Headache
Fever
Nausea and/or vomiting
Neurological weakness, numbness in the arms and legs, bowel or bladder incontinence
Walking problems
Treatment consists of intravenous antibiotics to combat the infection that caused the abscess. In some cases, if there is difficulty moving around or are experiencing numbness, then surgery is required to drain the abscess or completely remove it.
Risk Factors
Spine infections can affect anyone. However, there are individuals with certain chronic health problems that have an increased risk. They include those with:
Kidney disease
Liver disease
Auto-immune diseases
Immune systems compromised like cancer and HIV
Individuals that have undergone a spinal surgical procedure are at greater risk post-surgery
Risk factors include:
Individuals that have had a spinal infection could be more susceptible to developing another.
Age – older adults
Malnutrition
Diabetes mellitus
Obesity
Smoking
Intravenous drug use
Certain areas of the back are more prone to infection. This includes the cervical/back of the neck and the lumbar/low back.
Surgical risk factors:
Long surgical procedure
Massive loss of blood
Multiple surgeries of the same area
Diagnosis
Early diagnosis can be the difference in treating the infection before damage to the spine develops or before the damage worsens. They are diagnosed through a variety of lab and imaging tests. These include:
Various lab tests
Blood work to examine white blood cell counts and markers for inflammation
X-Rays
CT scan
MRI
Outcome
These infections are rare, but they are serious and early treatment is recommended for optimal outcomes. Early diagnosis in the early stages can be successfully treated with antibiotics, rest, and spinal braces. Doctors, spine specialists, chiropractors, and physical therapists will work with the individual to provide a thorough diagnosis, personalized treatment plan, and long-term outcomes.
Body Composition
Practice Mindfulness
Practicing mindfulness can help identify triggers of negative thoughts and behavior. Mindfulness is unique to each individual. Sitting quietly and meditating for 20 minutes is not for everyone. Instead, try a five-minute guided meditation, writing, or music listening. The best time to meditate is in the morning after waking up. This helps set the day’s objectives, what’s important and what can wait in a clear fashion. Mindfulness practice has been shown to reduce stress and feelings of anxiety.
Journaling is a great way to find out about yourself. It can be done with pencil/pen and paper, on a computer, tablet, or phone. Take a few minutes to write some ideas, feelings, emotions that can help put things in perspective. Examples could be, writing something that makes you happy/proud, something that you want to improve, and a goal. There is also mindful listening that can help reduce stress by focusing attention. Instead of turning on the news or checking email first thing, listen to a favorite podcast or music. The same applies to over-phone use. During some downtime instead of scrolling through social media, etc, take a breath and listen to your mind and self.
References
American Association of Neurological Surgeons. Spinal Infections. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx. Published May 2016. Accessed December 29, 2016.
Stat Pearls. (2021). Diskitis. https://www.ncbi.nlm.nih.gov/books/NBK541047/
Stat Pearls. (2021). Spinal Epidural Abscess. https://www.ncbi.nlm.nih.gov/books/NBK441890/
Frontiers in Medicine. (2014). Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. https://www.frontiersin.org/articles/10.3389/fmed.2014.00007/full
Microorganisms. (2020). Spinal Infections: An Update. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232330/
The Spine Journal. (2021.) “Long term quality of life outcome after spondylodiscitis treatment.” https://www.thespinejournalonline.com/article/S1529-9430(21)00783-X/fulltext
Individuals that go through severe low back pain caused by degeneration, herniated discs, vehicle, personal, work, and sports injuries, surgery, or spinal fusion is usually a last resort if non-invasive treatments fail to provide relief or not enough relief. Patients try to avoid spinal fusion because it can be an intense experience and requires a year-long recovery period. Unfortunately, individuals still experience discomfort and pain after surgery. Do individuals want to know what other treatment options are available, including chiropractic care?
Doctors will inform post-op patients of the risks involved with chiropractic therapy. However, chiropractic medicine can bring natural pain relief after surgery. Chiropractic treatment requires that an individual be adequately or fully healed before beginning a personalized treatment plan. At Injury Medical Chiropractic and Functional Medicine Clinic, we consult patients post-surgery about the effectiveness of rehabilitation spinal adjustments and physical therapy massage.
Wait Time After Surgery
Spinal fusion surgery involves removing the discs between two or more vertebrae and fusing the bones with metal screws and plates. The objective is to correct conditions like herniated discs and degenerative diseases by immobilizing the spine in that area. It can take at least three months for the vertebrae to fuse for a fully immobilized graft. Once the graft is complete, a few months of physical therapy are recommended to loosen/stretch and strengthen the muscles around the graft. Initial recovery combined with physical therapy typically takes a full year for a complete recovery.
It is during recovery where it can be difficult and for discomfort and pain to present. The reason is patients are recommended to avoid any twisting, bending, over-reaching motions, or the graft could break. This can make an individual take on awkward poses/postures, flexing and contracting muscles incorrectly, causing strain. The result is added discomfort and/or pain.
How Chiropractic Helps
Spinal fusion is not guaranteed to alleviate an individual’s back pain completely. But many do experience discomfort or pain post-surgery. This could be for a little while or longer, depending on their condition or injuries. Fortunately, chiropractic treatment can help bring pain relief through mobilization, manipulation, and massage techniques. Manipulations’ objective is to adjust and/or realign the bones of the spine and other areas of the body. Because of the intricacy of spinal manipulations, many who have undergone back or spinal fusion surgery are hesitant to seek chiropractic treatment. Discuss possible chiropractic care with your physician to determine if the surgical graft is strong enough to withstand spinal manipulations. If the graft is adequately/fully healed and your physician believes it can endure mild adjustments, reach out to a chiropractor to discuss a customized treatment plan.
Body Composition Testing
Poor Leg Skeletal Muscle Mass
The gluteal muscles or buttock muscles are the largest muscle group in the body. Individuals can start losing bone density by their 30s. This increases the risk of injury and further bone density loss. Bone density loss is a natural process, but the process can be accelerated for individuals with under-developed skeletal muscle mass. The health of muscles and bones are closely linked. Researchers found that individuals with less muscle mass than average for their height tended to have narrower and thinner bones. This resulted in limited lower bending strength.
Decreased muscle mass was shown to be linked to balance problems and increased risk of falls. There is a higher prevalence of sarcopenia or muscle wasting for patients with hip fractures and a reduction of leg muscle mass. The combination of:
Low muscle mass
Low bone density
Hip fractures
It can have lifelong consequences
References
Fernandez, Matthew et al. “Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,11 (2016): 3495-3512. doi:10.1007/s00586-015-4148-y
Keller, Glenda. “The effects of massage therapy after decompression and fusion surgery of the lumbar spine: a case study.” International journal of therapeutic massage & bodywork vol. 5,4 (2012): 3-8. doi:10.3822/ijtmb.v5i4.189
O’Shaughnessy, Julie et al. “Chiropractic management of patients post-disc arthroplasty: eight case reports.” Chiropractic & osteopathy vol. 18 7. 21 Apr. 2010, doi:10.1186/1746-1340-18-7
Perrucci, Rachel M, and Christopher M Coulis. “Chiropractic management of post-spinal cord stimulator spine pain: a case report.” Chiropractic & manual therapies vol. 25 5. 6 Feb. 2017, doi:10.1186/s12998-017-0136-0
Szulc, Pawel et al. “Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study.” Journal of bone and mineral research: The American Society for Bone and Mineral Research vol. 20,5 (2005): 721-9. doi:10.1359/JBMR.041230
Many doctors/surgeons rely on the widely adopted lumbar spinal fusion. However, experts have asserted that lumbar total disc replacement or TDR should be made available and increased for treating degenerative disc disease and other spinal conditions. Individuals interested in total disc replacement, the ability to have it done, and if insurance will pay? What to know about TDR and fusion before deciding and moving forward.
Total Disc Replacement
Spinal fusion has been the traditional approach for relieving lower back pain. In this procedure, a bone graft is inserted between two or more vertebrae. This eliminates movement that causes pain or could be dangerous to the individual. Total disc replacement demands more on a technical level than spinal fusion. However, the worn-out, injured, or damaged disc is fully replaced, even a completely degenerated disc, with a metal and/or plastic one. Benefits from lumbar TDR surgery include:
Shown to be a safe procedure with minimal complications
Significant improvement in health and quality of life
High rates of successful outcomes
Mobility is preserved
Who Needs Disc Replacement?
Low back problems affect more than a third of the population. This can come from:
Personal
Work
Sports
Automobile injuries
Aging
All are risk factors
Fusion or Total disc replacement
Fusion reduces and eliminates motion around the affected area which also changes with the spine’s mechanics. It can also place increased stress on the surrounding segments. However, the lack of motion is to eliminate the pain. Total disc replacement does increase mobility, but it can’t fully relieve the pain. It can relieve pain generated from the disc but not from other causes. TDR has been shown to:
Provides motion preservation
Reduces staying at the hospital
Provides long-term durability
Lower reoperation rates compared to fusion
Total disc replacement issues:
The procedure is more time-consuming
A lot of time making decisions
A lot of time preparing
An example could be the patient has a narrow disc space. Looking at the X-rays of the discs above and below, the surgeon has to make sure they choose the right size. Next, the narrow space needs to be mobilized back to a normal height that cannot be too high or too short. Finally, the surgeon has to make sure that the disc is anchored and fits properly.
Why Surgeons Still Choose Fusion?
Despite the benefits, there are reasons why surgeons still choose fusion.
There are strict rules as to when TDR can be used. This means insurers are prone only to approve fusion procedures.
The surgical technique is challenging. TDR surgery is a highly demanding procedure. As a result, many doctors specializing in fusion for 20 years or more can be reluctant to perform the procedure.
Complications and revision surgeries. Reoperations are sometimes necessary, but this happens in both fusion and TDR.
Individual Needs
Fortunately, most individuals with lower back problems never need total disc replacement. And those that do have severe pain/conditions are recommended to try non-invasive/surgical treatment. This ranges from:
Chiropractic
Physical therapy
Massage
Imaging and lab tests will be required. However, if an operation is necessary, ask questions about both procedures. For example, if a surgeon insists that fusion is the only option, ask why total disc replacement is not an option?
Body Composition Testing
Protein and Weight Loss
Protein is one of three basic macronutrients found in food. Proteins are made up of smaller units called amino acids. There are 22 amino acids, with 9 of these being essential. This means the body needs them, as the body cannot produce them. These essential amino acids can be obtained by eating protein-rich foods like:
Eggs
Meat
Fish
Vegetarian/vegan options include:
Nuts
Seeds
Beans
Tofu
Generally, all the essential amino acids cannot be obtained from just one food. Therefore it is recommended to eat a variety of animal and plant-based proteins. Protein is in almost every structure and function of the body.
Antibodies
These proteins fight off any infections, bacteria, etc.
Repair, maintenance, and structural
Proteins are the building blocks of the body’s muscles, bones, skin, and hair.
Hormones
Chemical messenger proteins are how cells and organs communicate. For example, Growth Hormone affects muscle gain and fat loss.
Enzymes
Not all proteins are enzymes; however, all enzymes are proteins. These proteins are catalysts or starters for chemical reactions in the body.
Transportation and storage
Some proteins carry molecules where they are needed. For example, hemoglobin or the red blood cells carry oxygen to cells, then transport carbon dioxide away.
Not getting enough protein in one’s diet can have serious consequences on the body’s health. Without enough protein, the muscles can begin to atrophy or waste away, taking Lean Body Mass, strength, and energy away as well.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. In addition, we provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Salzmann, Stephan N et al. “Lumbar disc replacement surgery-successes and obstacles to widespread adoption.” Current reviews in musculoskeletal medicine vol. 10,2 (2017): 153-159. doi:10.1007/s12178-017-9397-4
Hopkins overview of Lumbar TDR (for consumers) https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement
“Comparison of Lumbar Total Disc Replacement With Surgical Spinal Fusion for the Treatment of Single-Level Degenerative Disc Disease: A Meta-Analysis of 5-Year Outcomes From Randomized Controlled Trials”, Zigler J, et al., Global Spine Journal, June 2018, PMC602295 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022955/
“Overview of Lumbar TDR” (for consumers); Johns Hopkins Medical Center https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement
Chiropractic treatment and physical therapy are treatment methods/approaches that are conservative, non-invasive, and are both practical options. Both address health concerns, like various types of pain, automobile, work, sports, and personal injuries. Both are focused on helping individuals achieve long-term results and maintain health.
Chiropractic and physical therapy are usually done in combination, as they complement one another. There are benefits and similarities between the two treatment options. Here are some general guidelines to decide which treatment option is best for your needs.
Primary symptoms
Chiropractors are known for the ability to provide quick relief to individuals dealing with pain and stiffness in the joints, particularly the spine. They are experts in spinal realignment and proper posture. If flexibility is limited or the joints are locking up, a chiropractor is the recommended choice.
Physical therapists or PTs are the experts in body biomechanics and soft tissue injuries. If an individual finds themselves moving differently because of pain or injury, training and exercise will help movement and maximum recovery.
Treatment style
Chiropractors follow a meticulous expert-based protocol for achieving the best results. They provide a hands-on approach to treatment that requires regular follow-ups and maintenance. This is an approach that some individuals prefer. Physical therapy treatment/rehabilitation programs are typically short-term. The average treatment usually lasts only 12 weeks. A physical therapist's primary objective is to provide a fundamental understanding of how to move properly and self-manage symptoms for the long term. This usually includes a balanced exercise program.
Insurance coverage
Insurance plans vary in what is covered. The first step is to see what an individual's insurance will cover. Benefits can be found online or by calling a representative to see how to get the care/treatment needed. Most plans cover some form of physical therapy. Chiropractic is also usually covered by insurance providers. Skipping the insurance can also be done with chiropractic clinics providing affordable options.
Options
There is no clear-cut answer as to which to see. A physical therapist or chiropractor. Individuals should follow a doctor's recommendations as to which treatment type would benefit them. If no recommendations have been given then take a look at a clinic’s website to see what they are about. Fortunately, many chiropractic clinics include physical therapists as part of their medical team. Both chiropractic and physical therapists provide dynamic benefits for increasing and maintaining overall health.
Body Composition
Hydration Guidelines
Drink according to thirst
The body knows when it needs water. Therefore drink when you are thirsty, not before. An adequate fluid intake should be timed according to feelings of thirst.
Estimate hourly sweat loss
Those that exercise or engage in regular physical activities for prolonged periods should weigh themselves before engaging in the exercise/activity. Then drink according to thirst as the event goes on, then weigh yourself after the activity. The goal is to maintain the same weight or be slightly less. If an individual weighs more than what they drank, then they drank too much.
Excess water consumption
If an individual is not thirsty, the recommendation is to not drink water in excess. Nausea and even vomiting could ensue. A simple indicator to determine if enough water is being consumed is to check urine color. If it is colorless or slightly yellow then an individual is drinking enough water.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: [email protected] phone: 915-850-0900 Licensed in Texas & New Mexico
References
American Association of Physical Therapists. www.apta.org
Cherkin, D C et al. “A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain.” The New England journal of medicine vol. 339,15 (1998): 1021-9. doi:10.1056/NEJM199810083391502
Fritz, Julie M. “Physical therapy in a value-based healthcare world.” The Journal of orthopaedic and sports physical therapy vol. 42,1 (2012): 1-2. doi:10.2519/jospt.2012.0101
Shrier I. Does stretching help prevent injuries? Evidence-based Sports Medicine. Williston, VT: BMJ Books; 2002.
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